Menstrual abnormality in adolescents are common. The periods may be heavy, irregular or scanty initially. Eventually the majority of these teenaged girls establish a normal cycle and are fertile.
The important causes of menorrhagia are : Dysfunctional uterine bleeding (95%). Anovulatory cycles → unopposed estrogen →endometrial hyperplasia → prolonged and heavy periods.
♦ Polycystic ovary syndrome (PCOS).
♦ Hypo- or hyperthyroidism.
♦ Idiopathic thrombocytopenic purpura.
♦ Von-Willebrand’s disease.
♦ Fibroid uterus.
♦ Sarcoma botryroides .
♦ Estrogen producing ovarian tumor.
Diagnosis is made by careful history taking and thorough clinical examination. Evaluation is especially indicated if the menstrual interval is < 22 days or > 44 days, lasts longer than one week or the bleeding is too heavy that anemia develops. Investigations are planned according to the clinical diagnosis. Investigations include, routine hematological examination, including bleeding time, clotting time, platelet count. Thyroid profile (TSH, T3,T4), clotting profile, and imaging study of the pelvis by ultrasonography may be needed. EUA and uterine curettage are rarely needed to exclude any pelvic pathology (pregnancy complications). The curetted material is sent for histopathological study.
MANAGEMENT: The girl needs adequate explanation, reassurance and psychological support. Rest and correction of anemia are helpful in majority of the cases.
ROLE OF HOMOEOPATHIC MEDICINES IN PUBERTY MENORRHAGIA:-
Belladonna:- This homeopathic medicine is used to manage excessive bleeding. The flow is mostly dark red and hot and once in a while it comes as decayed blood. The related side effect is a pain in the back.
Crocus sativus:- This homeopathic cure is generally used by a large number of homeopathic doctors. The bleeding is extremely thick at times. The blood flow consists of threads or strings and is usually very dark.
Erigeron:- During menstrual cycle, since the bleeding is dark and profuse, an important side effect, which is very common ,is burning urine and irritation in the rectum.
Ferrum met:- Women who are having long and heavy periods that tends to come early are better off with this cure. The people who are weak and pale are the appropriate individuals for this cure.
Cyclamen:- During periods, the women have extreme pain that feels like they are in labour and the blood flow is thickened. After periods, they have swelling and tenderness in their breasts and sometimes also experience a milky secretion.
Crotalus horridus:- One of the effective Homeopathic medicines for internal bleeding. Delayed periods and the blood is usually a diluted, thin, and light liquid